Individual provider Active NPI

Tanya Rae Bednarek, MSW, LICSW, LADC

  • Clinical Social Worker
  • Duluth, MN
National Provider Identifier
1447727425
Registry record updated Sep 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29306 Issued in MN
Practice address
810 E 4TH St
Duluth, MN 55805-2147
Phone
(218) 728-4491
Fax
(218) 302-8698
NPI assigned
Oct 29, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 305126 MN
Clinical Social Worker 1041C0700X 29306 MN Primary

Addresses

Primary practice location

810 E 4TH St
Duluth, MN 55805-2147

Mailing address

1401 East 1St Street
Duluth, MN 55805-2407
Phone (218) 728-4491

Other practice location 1

1401 East 1st Street
Duluth, MN 55805-2407
Phone (218) 728-4491

Other practice location 2

325 11th Ave
Two Harbors, MN 55616-1300
Phone (218) 834-5520

Other practice location 3

40 11th St
Cloquet, MN 55720-1817
Phone (218) 879-4559

Other practice location 4

120 W 2nd St
Duluth, MN 55802-2017
Phone (218) 728-4491

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013000364 MN Practitioner - Clinical Social Worker 6406201235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Human Development CenterGroup PAC ID 2961485909, 39 clinicians

Practice addresses (Care Compare)

810 E 4TH St
Duluth, MN 55805-2147
Phone (218) 728-4491

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
305126MNMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightwater Health Dba Human Development Center Addiction (Substance Use Disorder) CurrentSince Sep 1, 2023 Accepting new patients
Brightwater Health Dba Human Development Center PastSince Sep 1, 2023 Accepting new patients

Locations

40 11th St
Cloquet, MN 55720
Phone (218) 879-4559

1401 E 1st St
Duluth, MN 55805
Phone (218) 728-4491

810 E 4th St
Duluth, MN 55805
Phone (218) 728-4491

120 W 2nd St
Duluth, MN 55802
Phone (218) 728-4491

325 11th Ave
Two Harbors, MN 55616
Phone (218) 834-5520

629 1st Ave
Two Harbors, MN 55616
Phone (218) 834-5520

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/humandevelopmentcenter/r4/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695945600000",
    "number": "1447727425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 EAST 1ST STREET",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052407",
            "telephone_number": "218-728-4491",
            "fax_number": "218-730-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E 4TH ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052147",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 East 1st Street",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558052407",
            "country_code": "US",
            "telephone_number": "218-728-4491",
            "fax_number": "218-730-2367",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 11th Ave",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161300",
            "country_code": "US",
            "telephone_number": "218-834-5520",
            "fax_number": "218-834-4264",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 11th St",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "557201817",
            "country_code": "US",
            "telephone_number": "218-879-4559",
            "fax_number": "218-879-0282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "120 W 2nd St",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "MN",
            "postal_code": "558022017",
            "country_code": "US",
            "telephone_number": "218-728-4491",
            "fax_number": "218-302-8698",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEDNAREK",
        "first_name": "TANYA",
        "middle_name": "RAE",
        "credential": "MSW, LICSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-29",
        "last_updated": "2023-09-29",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "305126",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "29306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.